Laserfiche WebLink
SAN JOAQUIN COU <br /> 'pp �oG <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.s ov-or lehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Date: <br /> Name of Facility: <br /> CiZip Code: <br /> ty: <br /> ddress: 12 � ,�� <br /> Telephone: _•3�\-i <br /> Owner/Operator: : <br /> C��;�a2 ��'�` Inspection Type: <br /> Program Element: 1�Z 5 Program Record: y <br /> on or After: Z <br /> SB180 Posted ❑Yes ❑ Rermit Posted <br /> Yes ❑ 1 Re-Inspection <br /> I <br /> s5—t C 1`11 <br /> --Su--o <br /> TSSt s4- -- ---- ---- - - `.531-- ---.-..- -- ---------------- ------- c n -- <br /> f C 3-7 15-1 <br /> Cc ri f <br /> i3tf' ± ! titWdlIta mm ? ereswastlt <br /> Name: Hand Sink: 02�- 'F Ch":: ppm Heat: 'F <br /> Exp.Date: ewashing k: 122 of Quat.Amm.: ppm Other: 'F <br /> ,Received By I Title: <br /> EH Specialist: Phone: 14 b <br /> Time in: 22 Time Out: 1 �5 Pag f <br /> EHD 16-24 (2atl pg) 413/13 y FOOD PROGRAM OIR CONTINUATION <br />